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General NPI Number Information
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NPI Number | 1427081660
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Entity Type | Organization
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Legal Business Name | THE WOODLANDS SKIN SURGERY CENTER PA
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 3786 FM 1488 RD STE 200
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City | CONROE
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State | TX
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Zip | 77384-4989
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Country | US
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Telephone | 281-364-8844
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Fax | 281-364-8833
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Provider Business Mailing Address
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Address Line | 3786 FM 1488 RD STE 200
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City | THE WOODLANDS
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State | TX
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Zip | 77384-4989
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Country | US
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Telephone | 281-364-8844
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Fax | 281-364-8833
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | TAMI MIMS
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Credential | CMC,CMOM
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Telephone | 281-364-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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